Fatores de prognóstico favorável em pacientes com glioblastoma
DOI:
https://doi.org/10.24220/2318-0897v23n1a2414Palabras clave:
Glioblastoma, Literatura de revisão por assunto, PrognósticoResumen
O objetivo deste trabalho foi identificar, os fatores que contribuem para o prognóstico favorável em pacientes com glioblastoma, de modo a fornecer dados que possam auxiliar no manejo desses pacientes. Trata-se de uma revisão sistemática da literatura científica, dos últimos nove anos, nas bases de dados PubMed e Web of Science, utilizando os descritores “glioblastoma and prognostic factors”. Aplicados os critérios de inclusão e exclusão, foram selecionados 23 artigos, os quais foram utilizados no desenvolvimento do trabalho. As variáveis mais estudadas foram idade, Karnofsky Perfomance Scale pré-operatório tratamento cirúrgico, terapia adjuvante, extensão da doença, alterações genéticas e moleculares. Fatores clínicos, genéticos, aspectos do tumor e tratamento mostraram ser importantes para o melhor prognóstico desses pacientes. Dentre esses, apresentam maiores chances de melhoria os mais jovens, com bom estado de performance inicial Karnofsky Performance Scale pré-operatório, tumor único, unilateral, tratado com cirurgia de ressecção extensa e radioterapia e quimioterapia adjuvantes (inclusive se for idoso), e panorama genético molecular favorável (aumento da expressão de N-myc downstream-regulated gene-1 em glioma em comparação com os tecidos normais do cérebro; hipermetilação do gene O6-metilguanina-metiltransferase; mutação Isocitrate Dehydrogenase-1 e ausência de expressão de Single-Stranded Deoxyribonucleic Acid-Binding Protein-2.
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